Access to General Practitioners during the second year of the COVID-19 pandemic in Portugal: a nationwide survey of doctors

Abstract

Background The Portuguese National Health System (NHS) provides universal coverage and near-free health care, but the population has high out-of-pocket expenses and unmet care needs. This suggests impaired accessibility, a key dimension of primary care. The COVID-19 pandemic has further affected access to health care. Understanding General Practitioners’ (GP) experiences during the pandemic is necessary to reconfigure post-pandemic service delivery and to plan for future emergencies. This study aimed to assess accessibility to GPs, from their perspective, evaluating determinants of accessibility during the second pandemic year in Portugal. Methods All GPs working in NHS Family Practices in continental Portugal were invited to participate in a survey in 2021. A structured online self-administered anonymous questionnaire was used. Accessibility was assessed through waiting times for consultations and remote contacts and provision of remote access. NHS standards were used to assess waiting times. Descriptive statistics were used to characterize the study sample. Associations between categorical variables were tested using the χ2 statistic and the Student t-test was used to compare means of continuous variables. Results A total of 420 GPs were included (7% of the target population). Median weekly working hours was 49.0 h (interquartile range 42.0–56.8), although only 14% reported a contracted weekly schedule over 40 h. Access to in-person consultations and remote contacts was reported by most GPs to occur within NHS time standards. Younger GPs more often reported waiting times over these standards. Most GPs considered that they do not have enough time for non-urgent consultations or for remote contacts with patients. Conclusions Most GPs reported compliance with standards for waiting times for most in-person consultations and remote contacts, but they do so at the expense of work overload. A persistent excess of regular and unpaid working hours by GPs needs confirmation. If unpaid overtime is necessary to meet the regular demands of work, then workload and specific allocated tasks warrant review. Future research should focus on younger GPs, as they seem vulnerable to restricted accessibility. GPs’ preferences for more in-person care than was feasible during the pandemic must be considered when planning for the post-pandemic reconfiguration of service delivery.

Access to General Practitioners during the COVID-19 pandemic in Portugal—A survey study of patient experiences in an urban setting

“…Also, longer doctor-patient relationships are more likely to occur with older GPs. A doctor survey conducted simultaneously with this patient survey found that older GPs reported shorter waiting times for their services [ 32 ]. As for self-perceived health status, healthier patients, having less care needs, are less likely to experience delays at some stage.…”

Association between sociodemographic and clinical features, health behaviors, and health literacy of patients with prostate cancer and prostate cancer prognostic stage

“…Telemedicine has been studied for cervical (Quinley et al , 2011) and lung cancer screenings (Magarinos et al , 2023), and it could be effective and increase screening uptake. Nevertheless, low digital literacy of the patients, problems in internet access in rural area, lack of human and technological resources may not allow telemedicine to reach its potential in substituting in-person consultations (Knudsen et al , 2021; Granja et al , 2023; Miranda et al , 2023).…”